DR. JEFFREY W WILDER (MD) – Obstetrics & Gynecology Physician, NPI 1164490611
Obstetrics & Gynecology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,735 OBSTETRICS/GYNECOLOGY in MI
Provider Addresses for DR. JEFFREY W WILDER (MD)
400 Hobart St
Cadillac, MI 496012331
Phone: (231) 876-7200
Type: Location
14651 W UPRIGHT ST
CHARLEVOIX, MI 497201266
Phone: (231) 547-4477
Fax: (231) 547-4753
Type: Location
14651 W Upright St
Charlevoix, MI 497201266
Phone: (231) 547-4477
Type: Location
1000 1st Dr NW
Austin, MN 559122941
Phone: (507) 433-7351
Type: Location
14700 Lake Shore Dr
Charlevoix, MI 497201999
Phone: (231) 547-3840
Type: Location
1250 E Michigan Ave Ste C
Grayling, MI 497387074
Phone: (989) 348-0550
Type: Location
829 N Center Ave Ste 200
Gaylord, MI 497351598
Phone: (989) 736-1210
Type: Location
1105 SIXTH ST
TRAVERSE CITY, MI 496842345
Phone: (231) 876-7200
Fax: (231) 547-8088
Type: Mailing
7985 S MACKINAW TRL
CADILLAC, MI 496018111
Phone: (231) 876-7200
Type: Location
Charlevoix Area Hostipal, 14700, Lake Shore Drive, Boulder Park, Charlevoix Township, Charlevoix County, Michigan, 49720, United States
CHARLEVOIX, MI 497201930
Phone: (231) 547-4024
Fax: (231) 547-8088
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040605000130 | I | Obstetrics/Gynecology | MI | TBD |
| I20190813003178 | I | Obstetrics/Gynecology | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Family Practice | WI | |
| Physician Assistant | MN | |
| - | MN | |
| Diagnostic Radiology | TN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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